Investigating Clinical Risk Factors Contributing to the Recurrence of Idiopathic Granulomatous Mastitis

Abstract
Background: Granulomatous mastitis (GM) is a chronic inflammatory disorder affecting breast tissue, with a high recurrence rate. Objectives: Regarding this impotence, this paper aims at proposing a retrospective approach to compile an extensive dataset of clinical information as well as to identify potential risk factors associated with GM recurrence. Methods: For this purpose, data on pathologically-confirmed cases of GM were retrospectively collected from the medical archives of the Shahid Beheshti Cancer Research Center, Iran, from March 2020 to February 2023. Then, the descriptive statistics were utilized to analyze demographic information, disease-related variables, patient-related variables, and details regarding treatment modalities. Evaluation of disease recurrence occurred 24 months following the initial GM diagnosis through clinical assessments, ultrasound, or mammography. Among the 100 accessible patients, 33 experienced recurrences within 24 months. Results: According to the obtained results, factors significantly associated with recurrence included body mass index (28.31 vs. 26.05), history of breastfeeding and its duration (22.44 months vs. 16.95 months) (90.9% vs. 72.7%), abortion, pain (72.7% vs. 46.3%), erythema nodosum (51.5% vs. 16.4%), hypertension (18.2% vs. 3%), thyroid disease (33.3% vs. 14.9%), rheumatologic disease (69.7% vs. 13.4%), dermal involvement (51.5% vs. 10.9%), joint involvement (85.9% vs. 39.4%), and the combined treatment modalities (45.5% vs. 11.9%). Moreover, the predictive model exhibited an overall accuracy of 83.3%. Conclusions: Finally, it can be concluded that abortion history, breastfeeding and its duration, combined treatment, pain, erythema nodosum, hypertension, thyroid or rheumatologic disease, dermatologic or joint signs, and Body Mass Index (BMI) could be the significant factors related to the recurrence of GM. Thus, special attention to these factors and management of baseline disease may have a predictive effect on the relapse of idiopathic granulomatous mastitis (IGM).
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